Pilsen-Little Village Community Mental Health Center, INC.
Clinic/Center, Mental Health (Including Community Mental Health Center) in Berwyn, IL. Organization (NPI-2).
NPI number1225418577
StatusActive
Last updated in NPPESApr 9, 2021
Details
- NPI
- 1225418577
- Entity type
- Organization (NPI-2)
- Legal business name
- Pilsen-Little Village Community Mental Health Center, INC.
- Organization subpart
- No
- Enumeration date
- Jun 2, 2015
- Certification date
- Apr 9, 2021
- Last updated
- Apr 9, 2021
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 261QM0801X | Clinic/Center, Mental Health (Including Community Mental Health Center) | – | – | Yes |
Other names
- Pilsen Wellness Center, INC (Doing Business As)
Practice location
2600 Ridgeland AveBerwyn, IL 60402-2725
Phone 708-317-5926
Mailing address
2319 S Damen AveChicago, IL 60608-4209
Phone 773-579-0832 · Fax 773-579-0762
Authorized official
Francisco Cisneros
Presicent/Ceo
7735790832
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